Seattle, January 13 2015

Mr. Anthony Armada
Swedish Chief Executive
747 Broadway

Seattle, WA 98122

Dear Tony,

This letter is to record my of?cial resignation as chair of the Surgery Quality Review
Committee and as a consequence as the vice-chair of the Department of Surgery. As we
have brie?y discussed over the phone recently, I sincerely cannot pursue in a healthy
way this role in the Department of Surgery and within our Medical Staff after the
administration that you lead has made the decision to promote to Chief of Neurosurgery
an individual whose care delivery and behavior, in a very short interval within the
Swedish community (16 months), has resulted in 32 Quality Variance Reports (QVRs)
and 17 Behavior Reports.

I understand the complexities of the situation and there may be more to the story than
what we publicly have been made aware of. I understand that no other internal
candidates have stepped forward for this position and I am also aware that it is felt by
the administration that searching externally could be a and potentially harmful
process. l, however. cannot continue as the Chair of a Committee that is to oversee the
360 degree quality of care delivery in the Swedish surgical world when my administration
promotes an individual that has shown very little respect for the Culture of Safety and
related processes, a concept we were all asked to embrace by your predecessor Dr.
Hochman and that you have personally repeatedly supported.

One of the pillars of the Safety Bundle is to be working in an environment where
collegiality in between peers and other members of the care delivery team is promoted
and where all are equal in patient safety. Though I do not work on the Cherry Hill
Campus and as such have not personally witnessed this physician in action, the number

of negative reports submitted by so many different individuals is, in my judgment, a
serious indicator of de?ciencies that will not make him a good leader for Neurosurgery,
whatever his surgical skills may be. I sincerely wish you that he proves me wrong on
this. More importantly however, if I am correct, I hope that the casualties will be minimal
and that Swedish will not lose good physicians, nurses and other supporting staff as a
result of this nomination.

A lot of rumors have surrounded how this individual was parachuted into Swedish. I
acknowledge that you were not involved in his initial hiring. Personally, I was disturbed
by what I was told of the process. The truth however is that, if in addition to being a
technically gifted surgeon with a huge referral, he was a good physician, a team player
and a consensus builder, I would have put aside the rumors and gladly continued to
work with him to succeed. If the rumors are true, this underlines a serious and very
dangerous problem: it is unacceptable that physicians be hired by administration
without the active participation and agreement of the medical staff whatever the external
influences may be.

Though I cannot support this Neurosurgery nomination Tony, I will continue as the
Medical Director of Thoracic Surgery and through my roles within the Swedish Cancer
Institute to fully support your efforts to pursue the growth of Swedish within the
Providence System, within our community, within the region and nationally.

Respectfully submitted,
Eric Valli?res, MD, FRCS

Medical Director SCI Thoracic Surgery
Surgical Director of the Lung Cancer Program

Swedish Cancer Institute

cc. June Alteras, Mike Butler, Thomas Brown, Clark Coler, Janice Connolly, Michael
Florence, Michael Hart, Rod Hochman, Peggy Hutchison, Ralph Pascualy, John Vassal.
(In alphabetical order)